Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.
Gerontologist. 2024 Jan 1;64(1). doi: 10.1093/geront/gnad044.
Tele-Savvy is a synchronous/asynchronous psychoeducation program for caregivers of community-dwelling persons living with Alzheimer's disease and related dementias (ADRD) designed to increase caregivers' competence and confidence (mastery) in caregiving. Its overall efficacy was tested in a randomized controlled trial.
This secondary data analysis examined the caregiver mastery and psychological health (i.e., perceived stress, depressive symptoms, and burden) outcome of 153 non-Hispanic Black American and White caregivers (31 non-Hispanic Black American and 122 White caregivers) from baseline to 6 months postintervention. Given the difference in the sample sizes of Black and White caregivers, a descriptive post hoc subgroup analysis was conducted of 21 non-Hispanic Black American and 20 White adult children and grandchildren caregivers.
In the overall sample, Black American caregivers demonstrated higher levels of mastery and lower levels of distress than White caregivers at baseline and across all time points. Over time, White caregivers, but not Black American caregivers, experienced significantly improved levels of mastery and significantly lowered levels of depression. Within the subgroup analysis, except for a moderate effect size in the management of situation scores over time among Black American adult children caregivers, similar results were obtained.
The findings highlight the strengths and shortcomings of the Tele-Savvy program in improving caregiver mastery and reducing negative psychological health outcomes. Intentionally tailoring the Tele-Savvy program to certain racial and caregiving groups may hold promise in meeting the needs of more ADRD caregivers.
NCT03033875.
Tele-Savvy 是一个针对居住在社区的阿尔茨海默病及相关痴呆症(ADRD)患者的照料者的同步/异步心理教育计划,旨在提高照料者在照顾方面的能力和信心(掌握)。其整体疗效已在随机对照试验中得到验证。
本二次数据分析了 153 名非西班牙裔黑人和白人照料者(31 名非西班牙裔黑人和 122 名白人照料者)从基线到干预后 6 个月的照料者掌握程度和心理健康(即感知压力、抑郁症状和负担)结果。鉴于黑人和白人照料者的样本量差异,对 21 名非西班牙裔黑人成年子女和孙辈照料者和 20 名白人成年子女和孙辈照料者进行了描述性事后亚组分析。
在总体样本中,黑人群体在基线和所有时间点的掌握程度都高于白人群体,且压力水平更低。随着时间的推移,只有白人群体照料者的掌握程度显著提高,抑郁程度显著降低,而非黑人群体照料者则没有这种变化。在亚组分析中,除了黑人群体成年子女照料者在管理情况得分方面的中度效应大小随时间的变化外,还得到了类似的结果。
研究结果强调了 Tele-Savvy 计划在提高照料者掌握程度和降低负面心理健康结果方面的优势和不足。有针对性地针对特定种族和照顾群体调整 Tele-Savvy 计划可能有助于满足更多 ADRD 照顾者的需求。
NCT03033875。